About the Commission

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The Geller Commission is an independent review into clinical pathways for people living with dementia in the UK.

The Commission brings together the UK’s foremost experts in dementia from the third sector, academia, research institutions and public health professionals to deliver an evidence based recommendations to the government of the day. It will draw its conclusion from quantitative sources, existing research and testimonials from those affected.

The Geller Commission will consider three overarching priorities:

• Prevention: early interventions and preventative measures to avoid initial hospitalisation and empower care providers to act.
• Protection: improving care for people with dementia in hospital to reduce the risk of readmission and expedite a return to a home setting.
• Simplification: identifying immediate barriers to timely or appropriate discharge

The Commission is led by Laurence Geller CBE.

Foreword

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The UK is at an important moment for dementia care. Today, people with dementia occupy one in six hospital beds in the UK, and projections indicate this figure will rise to one in four by 2040, at a cost to the UK taxpayer of £2.8 billion annually.

As our nation ages, the challenge will only grow. With life expectancy increasing, we must support people to not only live longer, but also sustain healthy and fulfilling lives. As people age above 60 a person’s risk increases, roughly doubling every five years. This means that, of those aged over 90, around 1 in 3 people will have dementia. An ageing population means exponential growth in dementia.

While hospitalisation is sometimes necessary and appropriate for acute health conditions, people with dementia are more vulnerable to deterioration in these settings that are so often characterised by stretched resources, time and staff. The cognitive and physical decline experienced during hospital stays, the distress caused by disorientating environments, and delayed discharge processes can all exacerbate frailty and erode dignity.

Provisions of care remain an inequitable “postcode lottery” across the country, with long waits, unclear pathways, limited access to specialist input and poor communication between hospital staff, carers and families. Families and carers pay the price – reporting an increased caregiving burden when their family member with dementia is hospitalised, as they are tasked with overseeing even the basic care requirements such as food.

Yet, for the first time, there is a clear opportunity to change the trajectory of dementia, underpinned by transformative scientific opportunity and recent breakthroughs in diagnostics, treatment and prevention.

Drawing on an umbrella review of studies combining the results of 77 unique papers, with a total of 1,483,077 participants, this report is the most comprehensive ever undertaken into the adverse impact of hospitalisation on those with dementia, and approaches to reduce the frequency and duration of dementia-related hospital occupancy.

This report should be a galvanising moment for transformative change. Based on its recommendations, we stand together to urge the government to prevent hospital admissions, reduce their length and impact on patients, and prevent avoidable readmissions. We must recognise the need for a systemic transformation of the health and care system that is failing to deliver the coordinated and continuous support that people with dementia deserve today. It doesn’t have to be this way – the UK has an opportunity to change course with the Modern Service Framework for Dementia and Frailty.

We are unanimous in our belief that the Framework must be ambitious and ensure that no matter who you are or where you live, your chance of dying from dementia will be reduced; and if you develop dementia, you will live longer with a better quality of life.

Read the full report here.

Michelle Dyson, CEO, Alzheimer’s Society

Laurence Geller CBE, Chair, The Geller Commission

Hilda Hayo, CEO, Dementia UK